脂蛋白相关磷脂酶A2对冠脉病变严重程度的预测价值
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南京医科大学科技发展基金(2017NJMU088)


Predictive value of lipoprotein⁃associated phospholipase A2 in the severity of coronary lesions
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    摘要:

    目的:量化评估脂蛋白相关磷脂酶A2(lipoprotein associated phospholipase A2,Lp-PLA2)水平预测冠脉病变严重程度的效果。方法:入选行冠状动脉造影及Lp-PLA2检测的患者共123例,评估Lp-PLA2对急性冠脉综合征(acute coronary syndrome,ACS)、多支病变及SYNTAX Ⅱ评分的预测价值。结果:Lp-PLA2与冠心病诊断、多支病变、SYNTAX Ⅱ评分等有相关性(P均<0.05)。Lp-PLA2诊断ACS和多支病变的灵敏度较高(分别为90.9%、80.0%),诊断SYNTAX Ⅱ评分≥23分及≥33分的特异度较高(分别为81.7%、87.4%)。Lp-PLA2是多支病变、SYNTAX Ⅱ评分≥23分及≥33分的独立危险因素(OR分别为1.004、1.003及1.004,P均<0.05)。亚组分析显示,Lp-PLA2水平升高可预测高血压患者多支病变(OR=2.800,P < 0.05)、高血压与糖尿病患者SYNTAX Ⅱ评分≥23分的风险较高(高血压亚组OR=3.586;糖尿病亚组OR=18.000,P均<0.05)。结论:Lp-PLA2可以有效预测冠脉病变严重程度,尤其是诊断ACS和多支病变的灵敏度和SYNTAX Ⅱ评分≥23分及≥33分的特异度较高,对高血压及糖尿病患者的冠脉病变预测价值更大。

    Abstract:

    Objective:To quantitative assess the effect of lipoprotein associated phospholipase A2(Lp-PLA2) level in predicting the severity of coronary lesions. Methods:A total of 123 patients who underwent coronary angiography and Lp-PLA2 detection were enrolled to evaluate Lp-PLA2 level in predicting acute coronary syndrome(ACS),multi-vessel lesions and SYNTAX Ⅱ score. Results:Lp-PLA2 was correlated with the diagnosis of coronary artery disease,multi-vessel lesions and SYNTAX Ⅱ score(all P < 0.05). Lp-PLA2 had high sensitivity in predicting ACS(90.9%)and multi-vessel lesions(80.0%),high specificity in predicting SYNTAX Ⅱ score ≥23(81.7%)and ≥33(87.4%). Lp-PLA2 was an independent risk factor for multi-vessel lesions and SYNTAX Ⅱ score ≥23 and ≥33(OR=1.004,1.003 and 1.004,respectively,all P < 0.05). Subgroup analysis showed that the higher concentration of Lp-PLA2 predicted the higher risk of multi-vessel lesions in hypertension(OR=2.800,P < 0.05)and higher risk of SYNTAX Ⅱ score ≥23 in hypertension and diabetes patients(OR=3.586 and 18.000,respectively,both P < 0.05). Conclusion:Lp-PLA2 can effectively predict the severity of coronary lesions,especially the sensitivity of ACS diagnosis and multi-vessel lesions and the specificity of SYNTAX Ⅱ score ≥23 and ≥33. The predictive value of Lp-PLA2 for coronary lesions is greater in hypertension and diabetes patients.

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龚晓璇,叶泽康,王 彤,马嘉政,滕建桢,李 振.脂蛋白相关磷脂酶A2对冠脉病变严重程度的预测价值[J].南京医科大学学报(自然科学版),2021,(10):1463-1467

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  • 收稿日期:2021-02-18
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  • 在线发布日期: 2021-11-05
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